Pediatric Optometry

Early eye examinations are vital to make sure children have normal, healthy vision so they can perform better at schoolwork or play.  Eye exams for children are very important to insure your child’s eyes are healthy and have no vision problems that could interfere with school performance and potentially affect your child’s safety.

When scheduling an eye exam for your child, choose a time when he or she usually is alert and happy.  Specifics of how eye exams are conducted depend on your child’s age, but generally the exams will include a case history, vision testing, determination of whether eyeglasses are needed, testing of eye alignment, an eye health evaluation and, if needed, prescription of eyewear.

According to the American Optometric Association (AOA), infants should have their first comprehensive eye exam at 6 months of age. Children then should have additional eye exams at age 3, and just before they enter kindergarten — at about age 5.  For school-aged children, the AOA recommends an eye exam every two years if no vision correction is required. Children who need eyeglasses or contact lenses should be examined annually or as recommended by their optometrist or ophthalmologist.

Some parents are surprised to learn that preschool-age children do not need to know their letters in order to undergo certain eye tests, even when they are too young or too shy to verbalize.  Your child’s eyes should be examined early for vision problems such as “lazy eye” (amblyopia), in which one eye usually is weaker than the other. With amblyopia, eye patching often is used to help strengthen the weaker eye.  Some common eye tests used specifically for young children are random dot stereopsis, retinoscopy, and LEA symbols.

Random dot stereopsis testing uses special patterns of dots and 3-D glasses to measure how well your child’s eyes work together as a team.

Retinoscopy is a test that involves shining a light into the eye to observe the reflection from the back of the eye (retina). This test helps eye doctors determine your child’s eyeglass prescription.

LEA symbols for young children are similar to regular eye tests using charts with letters, except that special symbols in these tests include an apple, house, square and circle.

In addition to nearsightedness, farsightedness and astigmatism, common vision problems of school children include:

Lazy eye (amblyopia). Your eye doctor will want to rule out amblyopia, or “lazy eye,” which is decreased vision in one or both eyes without detectable anatomic damage. Unfortunately, amblyopia is not always correctable with eyeglasses or contact lenses and may require eye patching to strengthen the weaker eye.

Misalignment of eyes (strabismus). Crossed or misaligned eyes (strabismus) can have different causes, such as problems with muscle control in the affected eye or eyes. Strabismus is a common cause of amblyopia and should be treated early in childhood so vision and eye teaming skills can develop normally.

Inability to maintain eye alignment when viewing near objects (convergence insufficiency). Eye doctors will assess the ability of eyes to pull inward (convergence) and maintain proper alignment for comfortable reading.

Focusing ability, depth perception and color vision. The eye doctor also may test your child’s focusing (accommodation) ability. Depth perception or ability to gauge distances between objects also may be examined, and color blind tests may be used to assess your child’s color vision. [Read more about color vision and how the eye refracts light.]

Anterior eye and eyelid health. Your eye doctor will closely examine your child’s eyelids to look for abnormal or infected eyelash follicles, bumps, eye discharge and swelling (edema). The doctor also will examine the cornea, iris, and lens to look for cloudiness (opacities) or other irregularities.